title: Metastatic carcinoma in the cervical lymph nodes from an occult primary: a conservative approach to the role of radiotherapy.
abstract: This retrospective study examines the results of treatment for cervical lymph node metastases from an unknown primary epithelial cancer of squamous cell or anaplastic histology. The analysis covers a series of 87 consecutive unselected patients at the Middlesex Hospital, London, in the years between 1954 and 1986. Fifty-eight patients received radiation therapy with a view to cure, 25 patients were treated with radiotherapy to a palliative dose, 1 patient only had a radical neck dissection, and 3 patients received no treatment apart from excision biopsy. In contrast to common practice in the United States, only a single patient received prophylactic radiation to the nasopharynx as part of the initial therapy. Overall actuarial survival for all patients (87) at 2 years was 43% and at 5 years 33%, and in the radically treated group (58) it was 52% and 40%, respectively. Only 6 of the 87 patients (7%) subsequently revealed a primary tumor above the clavicles. Overall disease control above the clavicles was achieved in 53% (46/87), but was 64% (37/58) in the radically treated group. Guidelines for radiation therapy are discussed in view of these results.
authors.affiliation: Meyerstein Institute of Radiotherapy and Oncology, Middlesex Hospital, London, U.K.
authors.forename: R G
authors.initials: RG
authors.lastname: Glynne-Jones
authors.forename: A K
authors.initials: AK
authors.lastname: Anand
authors.forename: T E
authors.initials: TE
authors.lastname: Young
authors.forename: R J
authors.initials: RJ
authors.lastname: Berry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary*; D002648:Child; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate